Techniques for C-T jxn manipulation (Full Version)

All Forums >> [RehabEdge Forum] >> Manual Therapy



Message

ptdan23 -> Techniques for C-T jxn manipulation (January 16, 2008 11:15:47 AM)

Just curious so I thought I would ask --- what techniques have you found most beneficial for manipulation of the cervicothoracic junction?

Dan



USAPT -> RE: Techniques for C-T jxn manipulation (January 16, 2008 1:23:58 PM)

Dan,
I perform the sitting rotation mobilization at C7/T1, T1/2, T2/3 (if able) to improve cervical AROM and is typically my favorite.



OAK -> RE: Techniques for C-T jxn manipulation (January 17, 2008 5:46:45 PM)

Seated traction manipulation works good for me.



Sebastian Asselbergs -> RE: Techniques for C-T jxn manipulation (January 18, 2008 8:00:40 AM)

OAK, you mean the "Double Nelson" technique ? If so, I agree.



jesspt -> RE: Techniques for C-T jxn manipulation (January 18, 2008 12:21:15 PM)

I use the "double nelson" for this as well, but I have found that I have difficulty with the technique in patients who have a lot of ROM of their shoulders and scapulae - I struggle with "locking out" the spine. Any suggestions/hints, etc?




OAK -> RE: Techniques for C-T jxn manipulation (January 18, 2008 1:13:38 PM)

quote:

ORIGINAL: Sebastian Asselbergs

OAK, you mean the "Double Nelson" technique ? If so, I agree.


That's the one!



TexasOrtho -> RE: Techniques for C-T jxn manipulation (January 18, 2008 2:06:06 PM)

I've seen this performed but am not familiar with it.  What is the rationale for having the hands placed behind the head?



Kaden -> RE: Techniques for C-T jxn manipulation (January 18, 2008 2:49:49 PM)

Rod,

Rationale for hands placed behind the head is to help lock the cervical spine.  You can have the patient cup the cervical spine and then your hands come over theirs to provide a gross compression to the cervical spine so when traction force is applied it tries to localize to the C-T junction.

Jess, I agree this manip is difficult to do in those without the necessary shoulder motion.  I haven't found any great tips - just haven't been able to use it.

A question to the rest of you.  Why choose a traction manip over a flexion or extension manipulation?  Just curious.  I was always taught distraction manips were probably the safest but wondering what others have been taught.  Along the same lines when do you choose to use a traction mobilization say for ankle versuse a posterior glide. etc. 



Kaden -> RE: Techniques for C-T jxn manipulation (January 18, 2008 3:00:11 PM)

Rod,

Here is an article in JOSPT if you have acess showing the manipulation that has been described above.


Intermittent cervical traction and thoracic manipulation for management of mild cervical compressive myelopathy attributed to cervical herniated disc: a case series. (includes abstract) Browder DA; Journal of Orthopaedic & Sports Physical Therapy, 2004 Nov; 34 (11): 701-12



TexasOrtho -> RE: Techniques for C-T jxn manipulation (January 18, 2008 6:56:36 PM)

Thanks Kaden.  I've seen some really significant improvements in CROM with cervicothoracic mobilization.  I've done a very generalized mobilization that is empirically effective.

The patient lays supine with a 1/2 foam roll placed at approximately T1-C7.  This is a sustained stretch for 15-30 seconds.  The foam roll is slid down to the middle-third of the thoracic spine and repeated...the lower thoracic spine follows.  It's basically a prolonged static thoracic extension mob.  From a strictly anecdotal perspective, I have seen significant improvements in both terminal shoulder flexion and cervical extension and rotation with this activity.




ptdan23 -> RE: Techniques for C-T jxn manipulation (January 21, 2008 7:26:32 PM)

quote:

ORIGINAL: USAPT

Dan,
I perform the sitting rotation mobilization at C7/T1, T1/2, T2/3 (if able) to improve cervical AROM and is typically my favorite.


USAPT,
I like this technique as well.  Only downside is that it can be a thumb-killer!
Dan



ptdan23 -> RE: Techniques for C-T jxn manipulation (January 21, 2008 7:30:18 PM)

quote:

ORIGINAL: TexasOrtho

Thanks Kaden.  I've seen some really significant improvements in CROM with cervicothoracic mobilization.  I've done a very generalized mobilization that is empirically effective.

The patient lays supine with a 1/2 foam roll placed at approximately T1-C7.  This is a sustained stretch for 15-30 seconds.  The foam roll is slid down to the middle-third of the thoracic spine and repeated...the lower thoracic spine follows.  It's basically a prolonged static thoracic extension mob.  From a strictly anecdotal perspective, I have seen significant improvements in both terminal shoulder flexion and cervical extension and rotation with this activity.




TexasOrtho,
I like this technique as well.  Tolerated by some better than others.  I will sometimes add in UE movements to promote the backward bending motion.
Dan



ptdan23 -> RE: Techniques for C-T jxn manipulation (January 21, 2008 7:30:44 PM)

Anyone have any thrust techniques that they use?

Dan



bonez -> RE: Techniques for C-T jxn manipulation (January 21, 2008 9:10:38 PM)

As the Chiro in the group I would be wrong not to respond to this question. Yes there are several thrust techniques to treat this area



ptdan23 -> RE: Techniques for C-T jxn manipulation (January 22, 2008 11:41:00 AM)

Bonez,
I know there are thrust techniques for this area - I use them.  I was just asking if anyone has some techniques that they have found particularly effective or maybe more effective than others.
Dan



wvupt03 -> RE: Techniques for C-T jxn manipulation (January 26, 2008 1:48:02 AM)

I too ues the "double nelson" technique. I learned it from Dr. Erhard, with the justification that it is a relatively safe technique and quite effective. I have performed it quite often with usually good success.



jma -> RE: Techniques for C-T jxn manipulation (January 26, 2008 9:41:06 AM)

Thanks for the article link.



Page: [1]



Forum Software © ASPPlayground.NET Advanced Edition 2.5.5 Unicode

0.078